Early last year, I was asked by the Minister for Prisons to lead a review of the 83 self-inflicted deaths of young people aged 18 to 24 in NOMS custody from April 2007 until the end of 2013. This was a daunting task made all the more so by being told that this was once-in-a-generation opportunity to have an impact on the lives of some of the most vulnerable individuals in society. (Photographs by Andy Aitchison at PRISONiMAGE, @prisonimage)
My colleagues and I started assessing evidence in April 2014 and submitted our report to Ministers exactly one year later. Our report, entitled The Harris Review: Changing Prisons, Saving Lives (Cm 9087) was published by the Ministry of Justice on July 1 – helpfully clashing with the proposals for airport expansion in London, meltdown in Greece and the aftermath of the atrocities in Tunisia. It can be read in full here.
Throughout the review, we were well aware that, whatever had been the events that led to them ending up in custody, the young people whose deaths we reviewed were also someone’s son or daughter, sister or brother, partner or even parent.
There is, of course, no simple or easy solution to preventing such deaths, if there was it would no doubt have been adopted years ago. However, the conclusions and 108 recommendations that we have made were not reached lightly but were rooted in the evidence considered.
That evidence included 54 written submissions, 26 hearings with senior experts, nine visits to prisons and YOIs (including meetings with young prisoners at each one), two listening days with the families of young people who had died, surveys of young adults in institutions, and 50 audio submissions from prisoners following broadcasts on National Prison Radio. In addition, we commissioned a literature review, a small qualitative study on staff experience and views, and the analysis of nearly forty years of data on self-inflicted deaths held by NOMS.
Central to the evidence was our detailed consideration of the 83 cases along with the cases of four children aged under 18 that we also considered. This also included asking a team of forensic psychiatrists to do an analysis of the clinical reviews conducted for the Prison and Probation Ombudsman’s investigations of the individual deaths.
The weight of this evidence demonstrated that the Review needed to look broadly at the underlying factors in each of the cases. As a result, the review is the most comprehensive independent consideration of penal policy in this country for 20 or 30 years. In effect, the Government has got a Royal Commission on Prisons in a third of the usual time and at a sixth of the normal cost.
Each of the deaths we considered represents a failure by the State to protect the young people concerned. And that failure is all the greater because the same criticisms occur time and time again in the investigation reports that followed each one. Put simply: lessons have not been learned and not enough has been done to bring about substantive change.
The evidence was clear. All young adults in custody are vulnerable. Some had had chaotic lives and complex histories; others had been subjected to child abuse, exposed to violence or repeated bereavement; many had been in foster or residential care; and often these issues had been confounded by a lack of maturity or mental health issues.
Despite the views of some tabloid newspapers, prisons and YOIs are grim environments, bleak and demoralizing to the spirit. And the impoverished regimes currently operating in most establishments mean that prisoners are not sufficiently engaged in purposeful activity. In practice, staff shortages do not even allow the delivery of planned core day activities that might help rehabilitation. Frequently medical and mental health appointments are missed because there is no-one to escort the prisoner to them.
The review concluded that there needs to be an inherent shift in the philosophy of prison in the UK and recommended that the MoJ should publish a new statement on the purposes of prison. This statement would make it clear that a primary purpose of prison is rehabilitation (along with keeping prisoners – and the public – safe and secure). And it would acknowledge that all persons deprived of their liberty, which is the sentence of the Courts, should nonetheless be treated with respect for their human rights.
Delivering this shift in philosophy requires leadership and that leadership must start with ministers who should reinforce these objectives in all their public pronouncements and private actions. Similarly, clear leadership is critical in prisons and YOIs to enable a cultural change that means that young adults (and for that matter other prisoners) are rehabilitated, valued and nurtured towards safer and more productive lives.
A serious disconnect
There was a serious disconnect between what those in charge think should be happening and what actually occurs. NOMS’ Prison Service Instructions are essentially sound and, if implemented, would deliver good practice. However, for a variety of reasons – cultural and resourcing – they are often not doing so in practice. And there are no adequate mechanisms in place for the leadership of the Service to assure themselves or Ministers that policies are or can be followed.
Many of the young adults whose cases were examined were going through a period of particular distress that might have passed if they had not been spending so much time inside their cell with nothing to do other than stare at potential ligature attachment points. It is all the more surprising therefore that NOMS centrally does not know how many functional safer cells exist in individual establishments or the number of hours prisoners spend out of their cells on purposeful activities.
It is also surprising that NOMS does not have a discrete policy concerning bullying or guidance for Governors on how to manage gang issues in their establishments.
The review concluded that the prison workforce needs to be developed and trained to a higher professional standard, if prisoners, particularly those who are vulnerable, are to be managed effectively, rehabilitated and kept safe. Staff need to be motivated, knowledgeable and compassionate.
A central recommendation is that the responsibility for the health, education, social care, safety and rehabilitation should be taken on by a new role. This Custody and Rehabilitation Officer would be a specialist, suitably-trained professional who would manage the journey through the prison of each individual on their caseload. And this caseload would have to be small enough – we envisaged no more than 15 or 20 prisoners per officer – that enough time would be given to each prisoner and to making sure that what is necessary for their safety and rehabilitation is delivered.
The review proposed that each prisoner should have an Individual Custody Plan that would be developed following a multi-disciplinary, holistic needs assessment. This would be a dynamic process revised regularly and reflecting any potential risk of self-harm.
In the cases examined, it was apparent that many of the young person’s problems and vulnerabilities, including mental health issues, had been evident from an early age. So why did so many of them end up in custody?
Much more needs to be done to address these problems and divert young people from the criminal justice system at an earlier stage in their lives. The review recommends that there is a cross-governmental approach to this – perhaps a Troubled Adolescents programme rather like the work done by Government on Troubled Families. This would aim to address the multi-faceted problems and needs of children and young people at an early age either before they start or as they begin to run into problems with the police.
Prison is a hugely expensive intervention and yet the benefits of the spend are questionable with a relatively low impact on crime and with rates of re-offending remaining high particularly among young adults. A reduction in the overall prison population would make it easier for prisons to provide an environment that meets appropriate standards of decency, safety and respect and at the same time can be more effective in rehabilitating prisoners.
The review concluded that the reinvestment and redirection of resources to the health and welfare system and to community alternatives to custody will better provide the specialist help that can be tailored to individual needs.
Delaying action until the resource position is easier is not an option. If the Government chooses to ignore the Review’s recommendations, young people will continue to die unnecessarily in our prisons and we will continue to waste countless millions of pounds in failing to rehabilitate those who could be rehabilitated, in locking up those for whom a non-prison option would be more appropriate, and in failing to intervene early enough to prevent people from entering the criminal justice system in the first place.
The changes we have proposed are urgent. We now wait for the Government’s response.